Your Excellencies,
Dear colleagues,
Distinguished delegates,
Friends,

In 1558, medical doctor William Bullein wrote as follows: "The best doctors in the world are Dr. Nutrition, Dr. Rest and Dr. Joy". Three great doctors, indeed! But almost 450 years later, I’d say Dr. Vaccine comes in as a good "number four".

And we have come together around this table, I hope, to get even better acquainted with all four of them. Moreover, tonight we invest a piece of our time to get to know each other better. To nurture friendship. And to build professional relationships in order to move ahead. Our aim being to join forces, and pool our resources, to invest in our future - our children.

The English author Samuel Butler once described immunization as "the medical sacrament equivalent to baptism". I’d say he was very much on target!

In our country we take immunization for granted. I remember vividly at school, when we lined up for a dose of vaccine -- I understand it was oral polio -- to be swallowed on a small piece of sweet bread.

Today, despite great progress, far too many children around the world are still denied this opportunity. We owe them a better start in life.

* * *

Allow me to dwell, for a few minutes, on the broader context within which immunization takes place – on some key developmental challenges, as I see them:

Firstly, I believe we need to rally even stronger support for what has been referred to as "balanced development".

– A development, that is, in which investment in human capital is seen as no less important than investment in physical infrastructure and technology. Only then can development be sustainable. Only then can poverty be overcome.

In a large number of countries, millions upon millions of poor and disadvantaged are denied access to basic social services. For those who stand in the dawn of life, this situation is a ticket to a continuous ride on the vicious circle of poverty.

Access to education, health, clean water and sanitation must be seen as basic human rights, and as cornerstones of development. Otherwise, I am afraid that our development concepts and schemes – growing in numbers almost every day now – will become meaningless, dusty abstractions.

Secondly, we must make sure that those we count upon to perform policy-wise are actually able to deliver.

- Basic social services are public goods. We therefore maintain that governments have the primary responsibility to ensure equitable access to them. And rightly so!

But the problem with capital "P" remains: In many countries, all over the world, the public sector – and public expenditure - are under pressure. When budget cuts are needed, health budgets – along with budgets for education - are often prime targets. Not because of ill will in the governments concerned. Not necessarily because their priorities are wrong, either. But simply because you have to slash the big budget lines in order to get substantial savings.

The budget cuts lead not only to less health services, but to poorer quality of services, while staff motivation is being undermined. Add to that many new challenges - such as HIV/AIDS, the spread of malaria, TB, and many more – and the conclusion becomes obvious : the government’s burden, in view of its resources, is quite formidable.

I, for one, do not believe that the response to this challenges lie solely in market mechanisms. Therefore, one obvious answer to this problem is that government and the public sector must be strengthened. Somewhere between our good intentions and our desired outcomes we depend upon – and will continue to depend upon - the public sector’s capacity and motivation to take on the challenges.

Therefore, in order for countries to take charge of and be true owners of their own development process, capacity building at country level is vitally important.

Capacity meaning ability to generate income and allocate domestic resources.
Capacity meaning access to information and knowledge.
Capacity meaning a minimum of human, institutional and technical infrastructure.
Capacity meaning being in charge of homegrown reform processes.
Capacity meaning access – meaningful access - to regional and global fora.

Still, I think the answer goes way beyond strengthening the public sector alone.

Therefore, and thirdly, we also need to think anew - and forge new partnerships.

- I believe in a robust public sector with the responsibility to create an enabling policy and institutional environment – an environment that allows all service providers, including the private sector, to join forces.

In short, I am convinced that public-private partnerships will form important building blocks in the common endeavor called capacity building, which I earlier referred to as being so vitally important .

* * *

Let me narrow my focus to the issue of immunization.

– As you all know, considerable resources have been invested over the years in high profile immunization efforts. High coverage rates have been reached. Polio is about to be eradicated.

Still, we have also seen setbacks. We have seen how good coverage rates have been eroded by failing delivery systems. In this respect, even the polio campaign has largely not been able to strengthen delivery of other vaccines.

In short, we need better results. We must find ways of sustaining high coverage rates where they are already high, and expanding them where they are still too low.

To get there – and this is my fourth point – I believe we need to better tailor the immunization efforts to the health systems within which the immunization actually takes place.

In year 2000, I should like to think that we are fairly well equipped to do so. At our disposal are two huge pools of resources:

- We can tap the lessons learned during years of targeted and successful immunization efforts - and some less successful.

- And we can draw on experience from a decade of strong efforts to improve health systems and health reform design.

The challenge now is to merge the two.

In other words, and fifthly, we need to look for synergies between sound health systems development and well targeted and well designed immunization efforts.

I believe GAVI represents a golden opportunity to build such synergy.

• Synergy between strengthening health systems and maintenance of high immunization coverage.

• Synergy between actors at country, regional and global levels – and between public and private entities.

• Synergy – ultimately - between immunization and poverty reduction.

* * *

Ladies and Gentlemen,

In 1955, upon administering the experimental polio vaccine to himself, his wife and his three children, Dr. Jonas E. Salk was reported as saying: "This is courage based on confidence, not daring, and this is confidence based on experience".

We should seek inspiration in these words; go to our task with the same confidence, basing our efforts on pools of experience far larger than Dr. Salk had 45 years ago.

This first day of our gathering here in Oslo has certainly increased my optimism on GAVI’s behalf. The enthusiasm among the partners, here tonight, is actually quite contagious. To my knowledge, there is no vaccine against enthusiasm – and I hope there never will be!

I look forward to continuous collaboration with all of you.

I hope you will enjoy your stay here in Oslo.

Thank you for your kind attention.